"From my teens through my twenties, I was always struggling with the same 20 pounds. I didn't eat excessive amounts, but I ate the wrong foods - a lot of sweets. I managed to lose 10 pounds through excessive aerobic exercise: I'd go to step class for an hour, then spend 45 minutes on a stair climber. But even that stopped working when I was in my early 30s.

"I was determined to lose 10 more pounds, and I wanted to eat better. So a year and a half ago I began to follow a flexible, healthy diet that I could adapt to my lifestyle. In two months I lost four pounds, and I stopped stressing out about food. Then I started strength training, and it made all the difference! I lost that last six pounds, and my figure changed. I'd been pear-shaped - my tops were size 8 but my bottoms were size 12 or 14. Now I can wear size 8 suits. My strength has increased tenfold. I got married a few months ago, and my husband was amazed by what I could lift when we were moving. He said, 'I can't believe how strong you are!'"

- Susan

* * * * *

"I went through some difficult changes in my life when I turned 40, and gained about 40 pounds. I avoided looking in the mirror - I wore huge tanks and covered myself up. Then my picture was in the local newspaper. I was appalled; I didn't recognize myself. I joined a weight loss class at my HMO and started doing aerobics, but I was having pain in my knees and hips. It hadn't occurred to me to add strength training until I saw an article about the research at Tufts. I decided to try it.

"The results have been a dream come true. I've lost the weight. I feel so much younger; I have so much more energy. I can do things I didn't think were possible. I used to run - I love how it makes me feel. But I'd written that off when I was 35, because my orthopedist said, 'Don't do it if it makes your knees and hips hurt.' Now I can run every other day for an hour. Because I feel stronger physically, I feel like a stronger person from a psychological standpoint. My picture was in the paper again recently, and I was quite pleased!"

- Isabel

THE DESPERATE STRUGGLE

So many women are battling to lose weight - yet they keep getting heavier and heavier. Since 1980, the incidence of overweight in American women has jumped by nearly 10 percent, according to the US Department of Health and Human Services. We don't need government statistics to see the decade-by-decade changes as we get older. One woman in five is overweight in her twenties. The problem intensifies during the later reproductive years: more than a third of women age 30 to 49 weigh too much. But the numbers really soar at menopause. An astonishing 52 percent of women in their fifties are overweight.

We all know that excess weight endangers health. Overweight triples the normal risk for heart disease and stroke, contributes to diabetes, and has even been linked to cancer. Dr. C. Everett Koop, former US Surgeon General, estimates that 300,000 Americans die from overweight-related causes each year! And millions of heavy women suffer from associated medical conditions that diminish the quality of their lives - from heartburn, to joint pain, to infertility. The burden is emotional as well. Many women are caught in a sad vicious circle: feeling depressed about their weight, seeking consolation in food, gaining more weight, and feeling even worse.

In desperation, some turn to risky medications and fad diets. But it's actually healthier to remain heavy than to lose weight the wrong way. I'm not just talking about the obvious dangers, like life-threatening side effects from drugs or nutritional deficiencies from unbalanced diets. Even the standard "sensible" advice - to eat 1000 to 1200 calories a day - puts women at risk because they lose so much lean tissue along with fat.

Preserving muscle and bone is vitally important for women. We start out with a lot less muscle and bone than men do, so we have a narrower margin of safety. Yet we live longer, so we're much more likely to reach an age where our lives are severely limited by muscular weakness or fragile bones.

But there's a much more immediate reason to be concerned about the loss of lean tissue: The less muscle you have, the harder it is to lose weight and to maintain the loss. Muscle is metabolically active; body fat isn't. So the smaller the proportion of muscle in your body, the lower your metabolic rate. To make matters worse, when you lose muscle, you become weaker and have less energy. Consequently, you're likely to burn fewer calories through physical activity. If you've ever hit a long plateau during a diet and remained stuck at the same weight despite all your efforts, this could be a reason.

The kind of dieting that leads to muscle loss also sabotages metabolism in another way: by cutting calories too drastically. Nature cleverly designed the human body so we could survive famine. If you put yourself on starvation rations - and for some women even 1200 calories a day is starving - you trigger hormonal shifts that help the body conserve calories instead of burning them. But when you're trying to lose weight, that's the last thing you want! Between the starvation effect and muscle loss, the wrong diet can reduce your metabolic rate by up to 30 percent.

These metabolic changes help explain the all-too-common phenomenon of "yo-yo" dieting: A woman manages to lose weight - but in the process, she undermines herself by depressing her metabolism. Maintaining the loss is a losing battle. She's ravenous all the time; her energy disappears. Eventually she gives in to her hunger and quickly regains.

After one of these discouraging cycles, a woman might console herself with the thought that she's no worse off than when she started her diet. Unfortunately, that's not true. The weight she lost was partly lean tissue, but nearly everything she regained is fat. Because she has less muscle now, it's going to be harder than ever to lose. What's more, repeated bouts of yo-yo dieting increase her risk for heart disease and stroke.

Once scientists and doctors understood the key role of muscle in metabolism, they began looking for ways to conserve lean tissue while shedding pounds. The answer turned out to be very simple: strengthening exercise.

THE FAT-FIGHTING POWER OF STRENGTH TRAINING

With strength training, you don't merely lose weight - you give yourself the leaner, healthier body of someone who's naturally slim. The benefits start with muscle and metabolism, but they go even further.

Here's how strength training helps you lose weight forever:

* Preserves muscle and bone as you shed fat

I've already explained that women may lose muscle when they diet. Another disturbing finding, of particular concern to women: At least seven well-controlled studies have shown that when you diet and lose weight, you lose bone too. A 1994 study done at the Queens Medical Centre in Nottingham England, studied pre-menopausal women who dieted for three months. Even though they followed a sensible food plan for modest weight loss (the average was just 7.5 pounds), they lost 1 percent of their bone mass. That may not sound like much, but it's an alarming change for so short a period in women under age 50, who normally lose no more than half a percent in an entire year.

We know that strength training can preserve and even build muscle when women are losing weight, and we think that it may help prevent bone loss as well. Several investigators currently are examining this question, and I look forward to seeing their results.

* Revs up your metabolism

Have you ever noticed that your male friends and relatives can eat much more than you do without gaining weight? Men really do have a metabolic advantage. But the explanation isn't their hormones, it's their muscles.

Strength training gives your metabolism a boost. You burn calories when you strength train - and you also burn more calories throughout the day when you have more lean tissue. In a study by Wayne Campbell, PhD, in our laboratory, which was published in the American Journal of Clinical Nutrition, the combined difference amounted to about 15 percent. That translates into an extra 300 calories per day for the average woman. Pat, one of the women in my pilot study, comments:

"You know how after you go off a diet you want to eat everything in sight, especially the things you haven't been eating? When you get rid of the fat and have more muscle, then you can eat a little more and not feel deprived."

* Firms and tightens, so you look trimmer

A pound of fat is bulkier than a pound of muscle. So if your weight loss is almost all fat, you'll look trimmer than if you lose lean tissue too. The women in my JAMA study all agreed not to lose weight. Nevertheless, many of them dropped one to three sizes because their bodies were more toned.
Nancy, one of the women in the group that tested the program in this book, reported:

"The other day I needed a dress for a wedding. My teenage daughter had a navy sheath that was perfect. But I had been size 14 going on size 16, and this was size 12. Also, the dress didn't have sleeves and I'd never worn anything sleeveless because my arms were always too flabby. I tried it on anyway. My daughter said, 'It looks great - your arms aren't flabby at all!' So that's what I wore to the wedding."

* Eases you into a more active lifestyle

Becoming more active is a not only a tremendous help to weight loss - it's also the key to staying slim. First, you burn extra calories when you move. Second, your metabolism remains slightly elevated for several hours after exercise. Third, there's evidence that being active helps tame your appetite. Moreover, an active lifestyle conditions your heart and lungs, making you fitter and healthier.

The problem is that many overweight women don't enjoy physical activity - and for good reason. Understandably, they feel self-conscious about pulling on spandex leggings and joining an exercise class. Even walking has little appeal for someone who's out of shape, especially if her joints ache and she becomes winded in a few minutes.

Strength training makes all the difference. The stronger your muscles, the easier it is to get moving. All the women in my JAMA study, as I've mentioned, previously were sedentary and had actually been directed not to begin an exercise program. Nevertheless, these revitalized women spontaneously began walking more, climbing more steps, and selecting more active leisure activities like dancing, hiking, and gardening. When we added it all up, after a year of strength training they had become 27 percent more active! We've now seen similar results in three other studies.

* Makes you healthier

How many times have you heard about a weight loss method that carries alarming risks - surgery that could shorten your life, pills that might damage your heart? Strength training is different. Instead of risks and side effects, it offers impressive health advantages. All women benefit from increased strength. Women over age 40 gain even more, because strength training reverses age-related muscle and bone loss; it even improves balance and flexibility. Indeed, as I'll explain in Chapter 3, strength training is one of the most effective ways to combat osteoporosis and the frailty too often associated with aging.

* * * * *

"When I was 36, I had a blood clot in my leg that went to my lung. I'm 48 now, and I'm looking toward menopause. I know I'm not a candidate for estrogen therapy. Strength training is a great alternative."

- Martha

* * * * *

* Helps you feel good about yourself

When I work with women who are strength training, some of the most significant changes I see are emotional. Physical strength is something that women rarely expect of themselves. But when a woman becomes strong, her self-confidence and self-esteem soar. The effect is especially powerful for women who are overweight and sedentary. Many suffer from a terribly negative self-image. They hate the way they look; they despair of being able to change. They feel physically incompetent and alienated from their own bodies.

Excess weight is a handicap for many forms of exercise - but not for strength training. Indeed, very heavy women are often quite strong. It's always a special joy to watch an overweight woman - someone who has never succeeded at any physical activity in her entire life - discover that she's not merely capable of lifting weights but actually good at it! Her whole view of herself is transformed. Being stronger physically makes her emotionally stronger too. Changes that previously seemed out of reach suddenly become doable.

Over and over, I've seen strength training open the door for weight loss. Dianne, one of the women in the group that helped me refine the program for this book, isn't sure exactly how much she weighed when she started because her scale doesn't register above 300 pounds. "I figure it was about 340," she says. Aerobic exercise was out of the question for her - even five minutes of walking left her winded and made her legs ache unbearably. "I wanted to exercise, but how could I? I was a ball of jelly," says Dianne. "Then I read about strength training. Boing! A light went off in my head. Here was something that would bring me to a point where I could be more active."

Dianne became the star of our test group, rapidly graduating from three-pound dumbbells, to five-pound, then eight-, ten-, and even fifteen-pound dumbbells for some exercises. Other changes followed. "Strength training gave me an overall sense of wellness, and it snowballed," says Dianne. "I started to eat better within two weeks. I could see myself getting more involved in my own life, being better to myself. I became more active in little ways - instead of sending my daughter upstairs to get my earrings or my watch, I'd go myself. I parked at the far end of the lot when I went to work."

By the end of ten weeks, Dianne had lost more than 35 pounds - and she glowed with vitality. The woman who could barely manage a five-minute walk when she started had joined a gym and was regularly walking 30 minutes on a treadmill. Says Dianne, "It's been a great uplift - I feel so much more positive." I'm thrilled with Dianne's progress so far, and look forward to watching her continue.

THE STRONG WOMEN STAY SLIM PROGRAM

The Strong Women Stay Slim program combines the power of strength training with nutritious eating and an active lifestyle. It's not just a weight loss program; it's a way to become healthier for a lifetime.

* Exercise you can do

Regardless how much you weigh, you can become active and fit. Instead of starting with aerobic exercise, this program begins with strength training. There's no huffing and puffing, no special clothes, no getting down on the floor (and struggling to get up again). You'll love the quick results you get with strength training. What a confidence booster!

If you've been sedentary, you'll systematically increase your activity in your third week on the program. By then you'll be stronger, so moving will be easier and more fun. Over the next eight weeks you'll slowly build up strength and endurance - never pushing yourself too far or too fast - until, by the tenth week, you'll join the 25 percent of American adults who get at least thirty minutes of moderate-intensity physical activity three or more times a week.

* A diet that's realistic

Most programs put all overweight women on the same 1000 to 1200-calorie diet. But one diet plan does not fit all. For many, a 1200-calorie diet is self-defeating because it cuts food intake too drastically. They try to comply, but hunger usually wins. The Strong Women Stay Slim program has 1200-, 1600- and 2000-calorie plans, so it adjusts for everyone. You'll learn how to eat to the limit - to adjust your intake so you continue to lose, while eating as much healthy food as possible.

Let's face it: If you're trying to lose weight, you can't eat as much as you want of whatever you want. But if deprivation has kept you from succeeding in the past, I can offer you two important promises:

First, you can eat the foods you love. There are no forbidden foods on this program. You can have a slice of chocolate cake on your birthday; you can order barbecued ribs at your favorite restaurant.

Second, you never need to be hungry. In addition to ample meals and snacks, you can have almost unlimited amounts of certain filling and nutritious foods.

* A vibrant new lifestyle

Of course, you want to lose weight to improve your appearance. But I hope you're also concerned about your health. Some weight-reduction measures force you to chose between looking good and feeling good, but not this one. Instead of worrisome side effects, this program offers added benefits - increased vitality and strength, improved mood and sleep, better balance and flexibility, plus reduced risk of heart disease, diabetes, cancer, arthritis and other debilitating conditions.

* * * * *

"I'm not just happy about the weight loss; I'm happy about how I'm losing weight. I love being strong. I like knowing that my diet is healthy and that I'm getting regular aerobic exercise. My husband keeps telling me how proud he is of what I'm doing."

- Alexandra

* * * * *

TEN WEEKS TO A NEW YOU

The Strong Women Stay Slim program lets you bypass the dangers and deprivation of quick weight loss programs. You lose weight steadily, at the sensible rate that doctors recommend - one-half pound to two pounds a week. But thanks to strength training, you'll see results just as quickly as with risky, counterproductive quick-loss programs. As you trade fat for muscle (which is more compact), you'll look trimmer. You'll also see fast results in the form of increased energy and strength. Most women experience thrilling improvements in less than a month.

Here's where you'll be at the end of ten weeks:

* If you needed to lose five to ten pounds, you will have reached this goal by losing half a pound to a pound per week over the entire ten-week period. You may have been battling that same five or ten pounds for years! Now, thanks to weight loss and exercise, you should be shapelier as well as slimmer. And the weight is gone for good.

* If you needed to lose between ten and fifty pounds, you will have lost about ten pounds. I realize that may not sound like much if you're used to the quick results of fad diets. But because you've also been doing strength training and aerobic exercise, you'll probably look much more than ten pounds slimmer. More important, this time you won't have to put up with inconvenient (and unnecessary) food restrictions or go hungry. Instead, you'll be following a sensible plan that will let you lose the remaining weight and stay slim and healthy for the rest of your life.

* If you need to lose more than fifty pounds, you'll shed ten to twenty pounds during the first ten weeks - a significant start. Adding to this loss will be the slimming effects of your fitness program. For the first time you'll have a food plan that doesn't starve you, and exercise that allows you to succeed. I'm sure you'll be brimming with self-confidence. Just keep going, and your weight loss will continue. You're establishing the lifestyle that will keep the weight off forever.

You can expect other changes after ten weeks, regardless of where you started:

* You'll feel stronger and more capable physically; you'll have much more energy.

* You'll sleep better at night.

* Your chronic aches and pains may disappear.

* Your self-esteem will increase; you'll feel happier. You'll look in the mirror and like what you see.

Not visible but vitally important are the improvements to your cardiovascular system, your muscles, your bones and your balance.

* * * * *

"In the past when I went on a diet, I would to try to motivate myself by thinking about reaching my ideal size. But the task seemed overwhelming. Eventually I'd say to myself, 'Forget it - I'll never get there.' This time, I'm getting immediate gratification and that keeps me going. My strength and energy increased right away; my stress level is way down. I'm out of bed before the alarm goes off. And people are starting to comment on how much better I look."
-

- Ruth

* * * * *

WHAT THIS BOOK PROVIDES

You're about to start a program that will change how you live. You'll lose weight safely and permanently. This book will tell you everything you need to know:

* Up-to-the-minute scientific information

The more you know, the more motivated you will be.

Chapter 2 explains what it takes to control appetite and get your metabolism on your side. You'll learn why some diets fail - and why this one will work.

Chapter 3 explains exactly how strength training - along with a more active lifestyle - promotes weight loss, tightens and trims your figure, and offers significant health benefits. Exercise not only helps you look and feel better right now, it also reduces your long-term risk for almost all major chronic diseases. No medication can match it.

Chapter 4 explains how a healthy diet helps you live slimmer as well as longer. Good nutrition tames hunger and cravings, so you lose weight more easily and keep it off forever. We don't yet know all the nutrients that produce these benefits, but I'll highlight what we've discovered so far.

* Detailed step-by-step instructions

I'll give you complete directions, and tell you how to adapt this program to your particular needs.

Chapter 7 gives you a strength training program - six basic moves designed for weight loss, plus optional supplemental exercises you can add later.

Chapter 8 provides directions for becoming more active, with self-tests that ensure you get on the right track and progress safely.

Chapter 9 presents the food plan, with basic instructions and menus that can be adapted to any lifestyle.

Chapter 10 will help you put everything together, so you're on your way.

Chapter 12 answers common questions about the program.

* Motivational savvy

It's not easy to make changes in your life, even when you know they're important. In our research at Tufts, where we need to follow volunteers for many months, we've worked very hard to learn how to motivate participants. I'm very proud of the fact that our dropout rates are among the lowest reported in the medical literature. Even if you're not coming into our labs every week, what we've learned can work for you.

Chapter 6 helps you decide what you should weigh - the number may surprise you.

Chapter 11 will tell you how to keep yourself on track once you get started - including how to overcome any obstacles you may encounter.

* Ten days of innovative menus and recipes based on the food plan

To get you off to a good start, I asked renowned cookbook author Steven Raichlen to prepare ten days of menus and recipes. As the recipes came in, I had great fun trying them. You'll be delighted - as my family and I were - to see how well you can eat on this plan.

You are about to start a program that will change your life forever. You're taking charge, and doing something wonderful for yourself. Expect a very positive experience, right from the start.